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560 Quileute Heights Lapush WA 98350 | |
(360) 374-9035 | |
(360) 374-5448 |
Full Name | |
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Speciality | Clinic/Center |
Location | 560 Quileute Heights, Lapush, Washington |
Authorized Official Name and Position | Jolene Winger (HEALTH DIRECTOR) |
Authorized Official Contact | 3603744058 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 189 La Push WA 98350-0189 Ph: (360) 374-9035 | 560 Quileute Heights Lapush WA 98350 Ph: (360) 374-9035 |
NPI Number | 1548329105 |
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Provider Enumeration Date | 12/08/2006 |
Last Update Date | 04/19/2024 |
Medicare PECOS PAC ID | 2769577899 |
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Medicare Enrollment ID | O20071003000707 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548329105 | NPI | - | NPPES |
TEZ090 | Other | WA | MEDICARE |
7084486 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Washington) | Primary |